Browse publications by year: 2019

Design, optimisation and reliability allocation for energy systems based on equipment function and operating capacity

Andiappan V, Benjamin MFD, Tan RR, Ng DKS

Heliyon, 2019 Oct;5(10):e02594.
PMID: 31720447 DOI: 10.1016/j.heliyon.2019.e02594

Designers of energy systems often face challenges in balancing the trade-off between cost and reliability. In literature, several papers have presented mathematical models for optimizing the reliability and cost of energy systems. However, the previous models only addressed reliability implicitly, i.e., based on availability and maintenance planning. Others focused on allocation of reliability based on individual equipment requirements via non-linear models that require high computational effort. This work proposes a novel mixed-integer linear programming (MILP) model that combines the use of both input-output (I-O) modelling and linearized parallel system reliability expressions. The proposed MILP model can optimize the design and reliability of energy systems based on equipment function and operating capacity. The model allocates equipment with sufficient reliability to meet system functional requirements and determines the required capacity. A simple pedagogical example is presented in this work to illustrate the features of proposed MILP model. The MILP model is then applied to a polygeneration case study consisting of two scenarios. In the first scenario, the polygeneration system was optimized based on specified reliability requirements. The technologies chosen for Scenario 1 were the CHP module, reverse osmosis unit and vapour compression chiller. The total annualized cost (TAC) for Scenario 1 was 53.3 US$ million/year. In the second scenario, the minimum reliability level for heat production was increased. The corresponding results indicated that an additional auxiliary boiler must be operated to meet the new requirements. The resulting TAC for the Scenario 2 was 5.3% higher than in the first scenario.

MeSH terms: Maintenance; Models, Theoretical; Osmosis; Programming, Linear; Reproducibility of Results; Nonlinear Dynamics; Thermogenesis; Data Compression; Physical Phenomena
Fulltext Management of gag reflex for patients undergoing dental treatment

Eachempati P, Kumbargere Nagraj S, Kiran Kumar Krishanappa S, George RP, Soe HHK, Karanth L

Cochrane Database Syst Rev, 2019 11 13;2019(11).
PMID: 31721146 DOI: 10.1002/14651858.CD011116.pub3

BACKGROUND: The gag reflex is an involuntary defence mechanism to protect the pharynx and throat from foreign objects. Gagging is a common problem encountered during dental treatment, making therapeutic procedures distressing and often difficult or even impossible to perform. Various interventions can be used to control the gag reflex: anti-nausea medicines, sedatives, local and general anaesthetics, herbal remedies, behavioural therapies, acupressure, acupuncture, laser, and prosthetic devices. This is an update of the Cochrane Review first published in 2015.
OBJECTIVES: To assess the effects of pharmacological and non-pharmacological interventions for the management of gagging in people undergoing dental treatment.
SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the Cochrane Oral Health's Trials Register (to 18 March 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2) in the Cochrane Library (searched 18 March 2019), MEDLINE Ovid (1946 to 18 March 2019), Embase Ovid (1980 to 18 March 2019), CINAHL EBSCO (1937 to 18 March 2019), AMED Ovid (1985 to 18 March 2019), and the proceedings of the International Association for Dental Research (IADR) online (2001 to 18 March 2019). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We also conducted forwards citation searching on the included studies via Google Scholar. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA: We included randomised controlled trials (RCTs), involving people who were given a pharmacological or non-pharmacological intervention to manage gagging that interfered with dental treatment. We excluded quasi-RCTs. We excluded trials with participants who had central or peripheral nervous system disorders, who had oral lesions or were on systemic medications that might affect the gag sensation, or had undergone surgery which might alter anatomy permanently.
DATA COLLECTION AND ANALYSIS: We independently selected trials, extracted data, and assessed risk of bias. We followed Cochrane's statistical guidelines. We assessed the overall certainty of the evidence using GRADE.
MAIN RESULTS: We included four trials at unclear risk of bias with 328 participants (263 adults and 65 children who were four years or older), in which one trial compared acupuncture and acupressure (with thumb, device and sea band) at P6 (point located three-finger breadths below the wrist on the inner forearm in between the two tendons) to sham acupuncture and acupressure with and without sedation. One trial compared acupuncture at P6 point to sham acupuncture. These trials reported both completion of dental procedure and reduction in gagging (assessor and patient reported) as their outcomes. One cross-over and one split-mouth trial studied the effect of laser at P6 point compared to control. One trial reported reduction in gagging and another reported presence or absence of gagging during dental procedure. Acupuncture at P6 showed uncertain evidence regarding the successful completion of dental procedure (RR 1.78, 95% CI 1.05 to 3.01; two trials, 59 participants; very low-certainty evidence) and uncertain evidence regarding the reduction in gagging (RR 2.57, 95% CI 1.12 to 5.89; one trial, 26 participants; very low-certainty evidence) in comparison to sham acupuncture. Acupuncture at P6 with sedation did not show any difference when compared to sham acupuncture with sedation (RR 1.08, 95% CI 0.91 to 1.28; one trial, 34 participants; very low-certainty evidence). Acupressure using thumb pressure with or without sedation showed no clear difference in completing dental procedure (RR 0.96, 95% CI 0.84 to 1.10; one trial, 39 participants; very low-certainty evidence; and RR 0.85, 95% CI 0.50 to 1.46; one trial, 30 participants; very low-certainty evidence; respectively), or reduction in gagging (RR 1.06, 95% CI 0.92 to 1.23; one trial, 39 participants; very low-certainty evidence; and RR 0.92, 95% CI 0.60 to 1.41; one trial, 30 participants; very low-certainty evidence; respectively) when compared to sham acupressure with or without sedation. Acupressure at P6 with device showed uncertain evidence regarding the successful completion of dental procedure (RR 2.63, 95% CI 1.33 to 5.18; one trial, 34 participants; very low-certainty evidence) and uncertain evidence regarding the reduction in gagging (RR 3.94, 95% CI 1.63 to 9.53; one trial, 34 participants; very low-certainty evidence) when compared to sham acupressure. However, device combined with sedation showed no difference for either outcome (RR 1.16, 95% CI 0.90 to 1.48; one trial, 27 participants; very low-certainty evidence; and RR 1.26, 95% CI 0.93 to 1.69; one trial, 27 participants; very low-certainty evidence; respectively). Acupressure using a sea band with or without sedation showed no clear difference in completing dental procedure (RR 0.88, 95% CI 0.67 to 1.17; one trial, 21 participants; very low-certainty evidence; and RR 1.80, 95% CI 0.63 to 5.16; one trial, 19 participants; very low-certainty evidence; respectively), or reduction in gagging (RR 0.88, 95% CI 0.67 to 1.17; one trial, 21 participants; very low-certainty evidence; and RR 2.70, 95% CI 0.72 to 10.14; one trial, 19 participants; very low-certainty evidence; respectively) when compared to sham acupressure with or without sedation. Laser at P6 showed a difference in absence of gagging (odds ratio (OR) 86.33, 95% CI 29.41 to 253.45; one trial, 40 participants; very low-certainty evidence) and reduction in gagging (MD 1.80, 95% CI 1.53 to 2.07; one trial, 25 participants; very low-certainty evidence) during dental procedure when compared to dummy laser application. No noteworthy adverse effects were reported. For acupuncture at P6, the trial authors were unsure whether the reported adverse effects were due to participant anxiety or due to the intervention. None of the trials on acupressure or laser reported on this outcome. We did not find trials evaluating any other interventions used to manage gagging in people undergoing dental treatment.
AUTHORS' CONCLUSIONS: We found very low-certainty evidence from four trials that was insufficient to conclude if there is any benefit of acupuncture, acupressure or laser at P6 point in reducing gagging and allowing successful completion of dental procedures. We did not find any evidence on any other interventions for managing the gag reflex during dental treatment. More well-designed and well-reported trials evaluating different interventions are needed.

MeSH terms: Adolescent; Adult; Child; Child, Preschool; Dental Care/methods*; Female; Gagging/prevention & control*; Humans; Male; Oral Health; Acupuncture Therapy/methods*; Randomized Controlled Trials as Topic; Young Adult
Fulltext An analytical model to minimize the latency in healthcare internet-of-things in fog computing environment

Shukla S, Hassan MF, Khan MK, Jung LT, Awang A

PLoS One, 2019;14(11):e0224934.
PMID: 31721807 DOI: 10.1371/journal.pone.0224934

Fog computing (FC) is an evolving computing technology that operates in a distributed environment. FC aims to bring cloud computing features close to edge devices. The approach is expected to fulfill the minimum latency requirement for healthcare Internet-of-Things (IoT) devices. Healthcare IoT devices generate various volumes of healthcare data. This large volume of data results in high data traffic that causes network congestion and high latency. An increase in round-trip time delay owing to large data transmission and large hop counts between IoTs and cloud servers render healthcare data meaningless and inadequate for end-users. Time-sensitive healthcare applications require real-time data. Traditional cloud servers cannot fulfill the minimum latency demands of healthcare IoT devices and end-users. Therefore, communication latency, computation latency, and network latency must be reduced for IoT data transmission. FC affords the storage, processing, and analysis of data from cloud computing to a network edge to reduce high latency. A novel solution for the abovementioned problem is proposed herein. It includes an analytical model and a hybrid fuzzy-based reinforcement learning algorithm in an FC environment. The aim is to reduce high latency among healthcare IoTs, end-users, and cloud servers. The proposed intelligent FC analytical model and algorithm use a fuzzy inference system combined with reinforcement learning and neural network evolution strategies for data packet allocation and selection in an IoT-FC environment. The approach is tested on simulators iFogSim (Net-Beans) and Spyder (Python). The obtained results indicated the better performance of the proposed approach compared with existing methods.

MeSH terms: Cloud Computing*; Computer Communication Networks; Computer Simulation; Delivery of Health Care*; Electrocardiography; Models, Theoretical*; User-Computer Interface; Fuzzy Logic; Databases as Topic; Support Vector Machine
Fulltext Comparative Efficacy and Safety of Neuroprotective Therapies for Neonates With Hypoxic Ischemic Encephalopathy: A Network Meta-Analysis

Lee CYZ, Chakranon P, Lee SWH

Front Pharmacol, 2019;10:1221.
PMID: 31708771 DOI: 10.3389/fphar.2019.01221

Context: Several interventions are available for the management of hypoxic ischemic encephalopathy (HIE), but no studies have compared their relative efficacy in a single analysis. This study aims to compare and determine the effectiveness of available interventions for HIE using direct and indirect data. Methods: Large randomized trials were identified from PubMed, EMBASE, CINAHL Plus, AMED, and Cochrane Library of Clinical Trials database from inception until June 30, 2018. Two independent reviewers extracted study data and performed quality assessment. Direct and network meta-analysis of randomized controlled trials was performed to obtained pooled results comparing the effectiveness of different therapies used in HIE on mortality, neurodevelopmental delay at 18 months, as well as adverse events. Their probability of having the highest efficacy and safety was estimated and ranked. The certainty of evidence for the primary outcomes of mortality and mortality or neurodevelopmental delay at 18 months was evaluated using GRADE criteria. Results: Fifteen studies comparing five interventions were included in the network meta-analysis. Whole body cooling [Odds ratio: 0.62 (95% credible interval: 0.46-0.83); 8 trials, high certainty of evidence] was the most effective treatment in reducing the risk of mortality, followed by selective head cooling (0.73; 0.48-1.11; 2 trials, moderate certainty of evidence) and use of magnesium sulfate (0.79; 0.20-3.06; 2 trials, low certainty of evidence). Whole body hypothermia (0.48; 0.33-0.71; 5 trials), selective head hypothermia (0.54; 0.32-0.89; 2 trials), and erythropoietin (0.36; 0.19-0.66; 2 trials) were more effective for reducing the risk of mortality and neurodevelopmental delay at 18 months (moderate to high certainty). Among neonates treated for HIE, the use of erythropoietin (0.36; 0.18-0.74, 2 trials) and whole body hypothermia (0.61; 0.45-0.83; 7 trials) were associated with lower rates of cerebral palsy. Similarly, there were lower rates of seizures among neonates treated with erythropoietin (0.35; 0.13-0.94; 1 trial) and whole body hypothermia (0.64; 0.46-0.87, 7 trials). Conclusion: The findings support current guidelines using therapeutic hypothermia in neonates with HIE. However, more trials are needed to determine the role of adjuvant therapy to hypothermia in reducing the risk of mortality and/or neurodevelopmental delay.

MeSH terms: Epoetin Alfa; Cerebral Palsy; Erythropoietin; Humans; Hypothermia; Hypothermia, Induced; Infant, Newborn; Magnesium Sulfate; Seizures; Odds Ratio; Randomized Controlled Trials as Topic; Hypoxia-Ischemia, Brain; PubMed; Network Meta-Analysis
Fulltext The DNA-Based Authentication of Commercial Herbal Products Reveals Their Globally Widespread Adulteration

Ichim MC

Front Pharmacol, 2019;10:1227.
PMID: 31708772 DOI: 10.3389/fphar.2019.01227

The herbal products, sold worldwide as medicines or foods, are perceived as low risk because they are considered natural and thus safe. The quality of these products is ineffectively regulated and controlled. The growing evidence for their lack of authenticity is causing deep concern, but the scale of this phenomenon at the global, continental or national scale remains unknown. We analyzed data reporting the authenticity, as detected with DNA-based methods, of 5,957 commercial herbal products sold in 37 countries, distributed in all six inhabited continents. Our global survey shows that a substantial proportion (27%) of the herbal products commercialized in the global marketplace is adulterated when their content was tested against their labeled, claimed ingredient species. The adulterated herbal products are distributed across all continents and regions. The proportion of adulterated products varies significantly among continents, being highest in Australia (79%), South America (67%), lower in Europe (47%), North America (33%), Africa (27%) and the lowest in Asia (23%). The commercial HPs' authenticity among the 37 countries included in our global analysis ranges between 0 and 100% from the total number of product reported for each specific national marketplace. For 9 countries, more than 100 products were successfully DNA-based authenticated and reported. From these countries, the highest percentage of adulterated commercial HPs was reported for Brazil (68%), followed distantly by Taiwan (32%), India (31%), USA (29%), followed closely by Malaysia (24%), Japan (23%), South Korea (23%), Thailand (20%), and China (19%). Our results confirm the large-scale presence of adulterated herbal products throughout the global market. The adulterated herbal products contain undeclared contaminant, substitute, and filler species, or none of the labeled species, which all may be accidental or intentional, economically-motivated and fraudulent. Due to the ever-increasing analytical sensitivity of the high throughput DNA sequencing, increasingly used for the untargeted, simultaneous multi-taxa identification, the proportion of adulterated HPs detected on the global market is expected to increase. In the context of the increasing demand for HPs, the limited supply of raw materials derived from many plant species, some of which being already nationally or internationally protected and having various degrees of trade restrictions, adds up to the differences and discrepancies between national HPs' regulatory frameworks and further increases the risks of adulteration of many types of herbal products. The globally widespread adulteration is a serious threat to consumers' well-being and safety, in spite of herbal products' claimed or expected health benefits.
Fulltext Embelin Protects Against Acute Pentylenetetrazole-Induced Seizures and Positively Modulates Cognitive Function in Adult Zebrafish

Kundap UP, Choo BKM, Kumari Y, Ahmed N, Othman IB, Shaikh MF

Front Pharmacol, 2019;10:1249.
PMID: 31708779 DOI: 10.3389/fphar.2019.01249

Purpose of the research: Epilepsy is a continuous process of neurodegeneration categorized by an enduring tendency to generate uncontrolled electrical firing known as seizures causing involuntary movement all over the body. Cognitive impairment and behavioral disturbances are among the more alarming co-morbidities of epilepsy. Anti-epileptic drugs (AEDs) were found to be successful in controlling epilepsy but are reported to worsen cognitive status in patients. Embelin (EMB) is a benzoquinone derived from the plant Embelia ribes and is reported to have central nervous system (CNS) activity. This study aims to evaluate the effectiveness of EMB against pentylenetetrazole (PTZ) induced acute seizures and its associated cognitive dysfunction. This was done via docking studies as well as evaluating neurotransmitter and gene expression in the zebrafish brain. The principal results: Behavioral observations showed that EMB reduced epileptic seizures and the T-maze study revealed that EMB improved the cognitive function of the fish. The docking study of EMB showed a higher affinity toward gamma-aminobutyric acid (GABAA) receptor as compared to the standard diazepam, raising the possibility of EMB working via the alpha subunit of the GABA receptor. EMB was found to modulate several genes, neurotransmitters, and also neuronal growth, all of which play an important role in improving cognitive status after epileptic seizures. Healthy zebrafish treated with EMB alone were found to have no behavioral and biochemical interference or side effects. The immunohistochemistry data suggested that EMB also promotes neuronal protection and neuronal migration in zebrafish brains. Major Conclusions: It was perceived that EMB suppresses seizure-like behavior via GABAA receptor pathway and has a positive impact on cognitive functions. The observed effect was supported by docking study, T-maze behavior, neurotransmitter and gene expression levels, and immunohistology study. The apparatus such as the T-maze and seizure scoring behavior tank were found to be a straightforward technique to score seizure and test learning ability after acute epileptic seizures. These research findings suggest that EMB could be a promising molecule for epilepsy induced learning and memory dysfunction.

MeSH terms: Neuroprotection; Behavior Observation Techniques; Animals; Brain; Cognition; Diazepam; Epilepsy; gamma-Aminobutyric Acid; Humans; Immunohistochemistry; Pentylenetetrazole; Seizures; Zebrafish; Benzoquinones; Receptors, GABA; Neurotransmitter Agents; Dyskinesias; Embelia; Ribes
Fulltext Cerebral Small Vessel Disease (CSVD) - Lessons From the Animal Models

Mustapha M, Nassir CMNCM, Aminuddin N, Safri AA, Ghazali MM

Front Physiol, 2019;10:1317.
PMID: 31708793 DOI: 10.3389/fphys.2019.01317

Cerebral small vessel disease (CSVD) refers to a spectrum of clinical and imaging findings resulting from pathological processes of various etiologies affecting cerebral arterioles, perforating arteries, capillaries, and venules. Unlike large vessels, it is a challenge to visualize small vessels in vivo, hence the difficulty to directly monitor the natural progression of the disease. CSVD might progress for many years during the early stage of the disease as it remains asymptomatic. Prevalent among elderly individuals, CSVD has been alarmingly reported as an important precursor of full-blown stroke and vascular dementia. Growing evidence has also shown a significant association between CSVD's radiological manifestation with dementia and Alzheimer's disease (AD) pathology. Although it remains contentious as to whether CSVD is a cause or sequelae of AD, it is not far-fetched to posit that effective therapeutic measures of CSVD would mitigate the overall burden of dementia. Nevertheless, the unifying theory on the pathomechanism of the disease remains elusive, hence the lack of effective therapeutic approaches. Thus, this chapter consolidates the contemporary insights from numerous experimental animal models of CSVD, to date: from the available experimental animal models of CSVD and its translational research value; the pathomechanical aspects of the disease; relevant aspects on systems biology; opportunities for early disease biomarkers; and finally, converging approaches for future therapeutic directions of CSVD.
Fulltext Antidiabetic, Antihyperlipidemic, Antioxidant, Anti-inflammatory Activities of Ethanolic Seed Extract of Annona reticulata L. in Streptozotocin Induced Diabetic Rats

Wen W, Lin Y, Ti Z

Front Endocrinol (Lausanne), 2019;10:716.
PMID: 31708869 DOI: 10.3389/fendo.2019.00716

Annona reticulata L. (Bullock's heart) is a pantropic tree commonly known as custard apple, which is used therapeutically for a variety of maladies. The present research was carried out to evaluate the possible protective effects of Annona reticulata L. (A. reticulata) ethanolic seed extract on an experimentally induced type 2 diabetes rat model. Male Albino Wistar rats were randomly divided into five groups with six animals in each group viz., control rats in group I, diabetic rats in group II, diabetic rats with 50 and 100 mg/kg/bw of ethanolic seed extract of A. reticulata in groups III and IV, respectively, and diabetic rats with metformin in group V. Treatment was given for 42 consecutive days through oral route by oro-gastric gavage. Administration of A. reticulata seed extract to diabetes rats significantly restored the alterations in the levels of body weight, food and water intake, fasting blood glucose (FBG), insulin levels, insulin sensitivity, HbA1c, HOMA-IR, islet area and insulin positive cells. Furthermore, A. reticulata significantly decreased the levels of triglycerides, cholesterol, LDL, and significantly increased the HDL in diabetic rats. A. reticulata effectively ameliorated the enzymatic (ALT, AST, ALP, GGT) and modification of histopathological changes in diabetic rats. The serum levels of the BUN, creatinine levels, uric acid, urine volume, and urinary protein were significantly declined with a significant elevation in CCr in diabetic rats treated with A. reticulata. MDA and NO levels were significantly reduced with an enhancement in SOD, CAT, and GPx antioxidant enzyme activities in the kidney, liver, and pancreas of diabetic rats treated with A. reticulata. Diabetic rats treated with A. reticulata have shown up-regulation in mRNA expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (NQO1), Heme oxygenase-1 (HO-1) and protein expression level of Nrf2 with diminution in Keap1 mRNA expression level in pancreas, kidney, and liver. From the outcome of the current results, it can be inferred that seed extract of A. reticulata exhibits a protective effect in diabetic rats through its anti-diabetic, anti-hyperlipidemic, antioxidant and anti-inflammatory effects and could be considered as a promising treatment therapy in the treatment of diabetes mellitus.

MeSH terms: Animals; Antioxidants; Blood Glucose; Blood Urea Nitrogen; Body Weight; Cholesterol; Creatinine; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 2; Drinking; Fasting; Insulin; Insulin Resistance; Liver; Male; Metformin; NAD; Quinones; RNA, Messenger; Seeds; Trees; Triglycerides; Uric Acid; Up-Regulation; Rats, Wistar; Malus; Annona; NF-E2-Related Factor 2; Rats; Heme Oxygenase-1
Fulltext Crystal structure of benzyl N'-[(1E,4E)-1,5-bis-(4-meth-oxy-phen-yl)penta-1,4-dien-3-yl-idene]hydrazine-1-carbodi-thio-ate

Arif Tawfeeq N, Kwong HC, Mohamed Tahir MI, Ravoof TBSA

Acta Crystallogr E Crystallogr Commun, 2019 Nov 01;75(Pt 11):1613-1619.
PMID: 31709078 DOI: 10.1107/S2056989019013458

In the title hydrazinecarbodi-thio-ate derivative, C27H26N2O2S2, the asymmetric unit is comprised of four mol-ecules (Z = 8 and Z' = 4). The 4-meth-oxy-phenyl rings are slightly twisted away from their attached olefinic double bonds [torsion angles = 5.9 (4)-19.6 (4)°]. The azomethine double bond has an s-trans configuration relative to one of the C=C bonds and an s-cis configuration relative to the other [C=C-C= N = 147.4 (6)-175.7 (2) and 15.3 (3)-37.4 (7)°, respectively]. The torsion angles between the azomethine C=N double bond and hydrazine-1-carbodi-thio-ate moiety indicate only small deviations from planarity, with torsion angles ranging from 0.9 (3) to 6.9 (3)° and from 174.9 (3) to 179.7 (2)°, respectively. The benzyl ring and the methyl-enesulfanyl moiety are almost perpendicular to each other, as indicated by their torsion angles [range 93.7 (3)-114.6 (2)°]. In the crystal, mol-ecules are linked by C-H⋯O, N-H⋯S and C-H⋯π(ring) hydrogen-bonding inter-actions into a three-dimensional network. Structural details of related benzyl hydrazine-1-carbodi-thio-ate are surveyed and compared with those of the title compound.
Fulltext Crystal structure, DFT calculation, Hirshfeld surface analysis and energy framework study of 6-bromo-2-(4-bromo-phen-yl)imidazo[1,2-a]pyridine

Khamees HA, Chaluvaiah K, El-Khatatneh NA, Swamynayaka A, Chong KH, Dasappa JP, et al.

Acta Crystallogr E Crystallogr Commun, 2019 Nov 01;75(Pt 11):1620-1626.
PMID: 31709079 DOI: 10.1107/S2056989019013410

The title imidazo[1,2-a] pyridine derivative, C13H8Br2N2, was synthesized via a single-step reaction method. The title mol-ecule is planar, showing a dihedral angle of 0.62 (17)° between the phenyl and the imidazo[1,2-a] pyridine rings. An intra-molecular C-H⋯N hydrogen bond with an S(5) ring motif is present. In the crystal, a short H⋯H contact links adjacent mol-ecules into inversion-related dimers. The dimers are linked in turn by weak C-H⋯π and slipped π-π stacking inter-actions, forming layers parallel to (110). The layers are connected into a three-dimensional network by short Br⋯H contacts. Two-dimensional fingerprint plots and three-dimensional Hirshfeld surface analysis of the inter-molecular contacts reveal that the most important contributions for the crystal packing are from H⋯Br/Br⋯H (26.1%), H⋯H (21.7%), H⋯C/C⋯H (21.3%) and C⋯C (6.5%) inter-actions. Energy framework calculations suggest that the contacts formed between mol-ecules are largely dispersive in nature. Analysis of HOMO-LUMO energies from a DFT calculation reveals the pure π character of the aromatic rings with the highest electron density on the phenyl ring, and σ character of the electron density on the Br atoms. The HOMO-LUMO gap was found to be 4.343 eV.
Fulltext Bis[2-(4,5-diphenyl-1H-imidazol-2-yl)-4-nitrophenolato]copper(II) dihydrate: crystal structure and Hirshfeld surface analysis

Chettri S, Brahman D, Sinha B, Jotani MM, Tiekink ERT

Acta Crystallogr E Crystallogr Commun, 2019 Nov 01;75(Pt 11):1664-1671.
PMID: 31709087 DOI: 10.1107/S2056989019013720

The crystal and mol-ecular structures of the title CuII complex, isolated as a dihydrate, [Cu(C21H14N3O3)2]·2H2O, reveals a highly distorted coordination geometry inter-mediate between square-planar and tetra-hedral defined by an N2O2 donor set derived from two mono-anionic bidentate ligands. Furthermore, each six-membered chelate ring adopts an envelope conformation with the Cu atom being the flap. In the crystal, imidazolyl-amine-N-H⋯O(water), water-O-H⋯O(coordinated, nitro and water), phenyl-C-H⋯O(nitro) and π(imidazol-yl)-π(nitro-benzene) [inter-centroid distances = 3.7452 (14) and 3.6647 (13) Å] contacts link the components into a supra-molecular layer lying parallel to (101). The connections between layers forming a three-dimensional architecture are of the types nitro-benzene-C-H⋯O(nitro) and phenyl-C-H⋯π(phen-yl). The distorted coordination geometry for the CuII atom is highlighted in an analysis of the Hirshfeld surface calculated for the metal centre alone. The significance of the inter-molecular contacts is also revealed in a study of the calculated Hirshfeld surfaces; the dominant contacts in the crystal are H⋯H (41.0%), O⋯H/H⋯O (27.1%) and C⋯H/H⋯C (19.6%).
Fulltext Identification of mutations in Malaysian patients with argininosuccinate lyase (ASL) deficiency

Ali EZ, Yakob Y, Ngu LH

Mol Genet Metab Rep, 2019 Dec;21:100525.
PMID: 31709144 DOI: 10.1016/j.ymgmr.2019.100525

Argininosuccinate lyase (ASL) deficiency impairs the function of the urea cycle that detoxifies blood ammonia in the body. Mutation that occurs in the ASL gene is the cause of occurrence of ASL deficiency (ASLD). This deficiency causes hyperammonemia, hepatopathy and neurodevelopmental delay in patients. In this study, the clinical characteristics and molecular analysis of 10 ASLD patients were presented. 8 patients were associated with severe neonatal onset, while the other 2 were associated with late onset. Molecular analysis of ASL gene identified four new missense variants, which were c.778C>T, p.(Leu260Arg), c.1340G>C, p.(Ser447Thr), c.436C>G, p.(Arg146Gly) and c.595C>G, p.(Leu199Val) and four reported missense variants, which were c.638G>A, p.(Arg213Gln); c.556C>T, p.(Arg186Trp), c.578G>A, p.(Arg193Gln) and c.436C>G, p.(Arg146Trp). In silico servers predicted all new and reported variants as disease-causing. Structural examination exhibited that all pathogenic variants affected the stability of the tetrameric ASL structure by disturbing the bonding pattern with the neighboring residues.
Conclusion: This study revealed the genetic heterogeneity among Malaysian ASL patients. This study has also expanded the mutational spectrum of the ASL.

MeSH terms: Ammonia; Argininosuccinate Lyase; Humans; Liver Diseases; Inactivation, Metabolic; Mutation; Urea; Genetic Heterogeneity; Hyperammonemia; Argininosuccinic Aciduria
Fulltext Ambient data analytic on indoor environment monitoring for office buildings in hot and humid climates

Ngah Nasaruddin A, Tee BT, Musthafah MT, Md Jasman MES

Data Brief, 2019 Dec;27:104534.
PMID: 31709283 DOI: 10.1016/j.dib.2019.104534

The rapid development of open source developmental boards incorporating microcontrollers on printed circuit boards has offered many alternatives in creating feasible, low cost indoor environment monitoring and controlling platforms. Data are collected and stored in predetermined locations throughout a series of communication activities between a network of active sensors and their processing units. However, the issue of data precision and accuracy are of real concern for generating baseline information. Therefore, with that in mind, the purpose of this paper is to accentuate an insightful trend of retrieving indoor environment data (temperature and relative humidity) for an office building in a hot and humid climate condition. The indoor parameters were monitored using a combination of a single board microcontroller with an active sensor with well calibrated thermal microclimate devices. Accordingly, it was found that proactive adjustment can be conducted in order to minimize waste.

MeSH terms: Calibration; Climate; Humidity; Microclimate; Temperature; Information Storage and Retrieval
Variations in mitochondrial DNA control region among Malay and Chinese subpopulations (sequence 16000-16200)

Ishar SM, Parameswaran K, Masduki NS, Rus Din RD

Mitochondrial DNA A DNA Mapp Seq Anal, 2019 12;30(8):843-847.
PMID: 31709874 DOI: 10.1080/24701394.2019.1687693

DNA variations are alterations found in DNA sequence, occurring in both nuclear DNA and mitochondrial DNA. Variations might differ in individual following population, respectively. The aim of this study was to find variations in target sequence of mtDNA (16000-16200) to be used as marker in Malay and Chinese population. A total of 30 buccal swab samples from 20 Malay and 10 Chinese subjects were collected and preserved on FTA card. The FTA card that contained DNA sample was punched to be included into polymerase chain reaction mixture. Amplification was carried out and the products were sequenced. Sequence variations were found in both Malay and Chinese populations. A total of nine variations (16129, 16108, 16162, 16172, 16148, 16127, 16173, 16099 and 16100) were found in Malay population while a total of seven variations (16129, 16104, 16111, 16109, 16164, 16170 and 16136) were found in Chinese population. Nucleotide position 16129 was found as variation in both Malay and Chinese populations. This study implies that np 16129 can be used as a marker for Malaysian population. For further investigation, the length of the target sequence may be increased to obtain more variations that can be used as markers. This will increase the discrimination power of Malaysian population.

MeSH terms: China; DNA, Mitochondrial/genetics*; Genetics, Population*; Humans; Malaysia; Genetic Variation/genetics*; Sequence Analysis, DNA*; Locus Control Region/genetics; Genome, Mitochondrial/genetics*
Fulltext Intraosseous lesion of phalanx: two similar cases but not the same

Jayaletchumi, G., Chung, W.H.

JUMMEC, 2019;22(1):0-0.
MyJurnal

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Fulltext Establishing freeze drying process for cortical and cancellous bone allograft cubes

Ariffin, A.A., Chan, H.H., Yusof, N., Mohd, S., Ng, W.M., Mansor A.

JUMMEC, 2019;22(1):66-71.
MyJurnal

Freeze drying is a dehydration method to dry bone under freezing environment, enabling removal of water
with no or minimial effects on bone strength and durability. Larger size bones obviously require longer freeze
drying time to reduce water content to the required level for long term storage at room temperature. For small
size bone cubes or chips, it is a normal practice to pool cortical and cancellous bones for freeze drying. The
study was aimed at determining if different type of bones of the same size influence the drying time. Human
bone cubes of 10 mm x 10 mm x 10 mm were prepared from cortical bone of tibiae and cancellous bone from
femoral heads. The bone cubes were freeze dried to reduce water content to less than 6%. Moisture content
was monitored using gravimetric method.Weight and density of cortical bone were significantly higher than
cancellous bone despite of having similar small size (p

MeSH terms: Bone and Bones; Dehydration; Desiccation; Freeze Drying; Freezing; Humans; Temperature; Water; Cortical Bone; Cancellous Bone
Fulltext Effectiveness of vision screening training module in improving the level of knowledge on vision screening among pre-school teachers in Klang Valley Malaysia

Omar, R., Knight, V.F., Tan, X.L., Ahmad Zahidi A.A., Mohd Saat, N.Z.

JUMMEC, 2019;22(1):58-65.
MyJurnal

Empowering lay screeners, such as pre-school teachers, on vision screening is a cost-effective way to
ensure larger populations of children can be screened. Although the validity of lay screeners in conducting
vision screening were reported in several studies, none showed data concerning improvement of the level
of knowledge among lay screeners after completing vision screening training, which could indicate the
effectiveness of the training program. This study aimed to determine the level of knowledge of pre-school
teachers before and after attending a training program. Sixty pre-school teachers from Tabika and Taska KEMAS
were randomly selected. The Study Group (n = 30) was given theory and practical training on vision screening,
whereas the Control Group (n = 30) was only given brief verbal instructions on how to conduct the screening. A
theory test containing 15 questions related to the training modules were administered to both groups, before
and after their training/briefing respectively. The findings showed that the level of knowledge among preschool
teachers in the Study Group (73.24 ± 11.73%) was significantly higher than the Control Group (56.22
± 13.11%) (p < 0.01). There was also a significant improvement in the level of knowledge among pre-school
teachers in the Study Group after the training (p

MeSH terms: Child; Child, Preschool; Cost-Benefit Analysis; Humans; Power (Psychology); Vision Screening; Knowledge; Control Groups; School Teachers; Educational Personnel
Fulltext The socio-demographic and clinical factors associated with quality of life among patients with brain pathology in a tertiary referral hospital in Malaysia

Das, Priscilla, Naing, NyiNyi, Nadiah Wan-Arfah, Naing Noor Jan, K.O., Yee, Cheng Kueh, Rasalingam, Kantha

JUMMEC, 2019;22(1):50-57.
MyJurnal

Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
profiles and clinical factors.

Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.

Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
female patients. Patients who were married had increased insomnia compared to the single patients. Employed
patients had better physical functioning and less financial difficulties compared with patients who were
unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
patients. All the findings were with p value less than 0.05.

Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.

MeSH terms: Appetite; Brain; Cognition; Constipation; Cross-Sectional Studies; Diarrhea; Dyspnea; Female; Health Status; Humans; Sleep Initiation and Maintenance Disorders; Male; Meningeal Neoplasms; Meningioma; Nausea; Pain; Quality of Life; Surveys and Questionnaires; Vomiting; Global Health; Tertiary Care Centers
Fulltext Systematic review of child abuse perpetrators worldwide: characteristics and risk factors

Hanani Nabilah, M.S.

JUMMEC, 2019;22(1):41-49.
MyJurnal

Child abuse is a part of violence and maltreatment towards a child. It has led to many immediate and longterm
consequences. The factors pertaining to the perpetrators of physical and emotional abuse were least
explored in the literature. The aim of this systematic review is to comprehend the factors of vulnerability
among the perpetrators of child abuse, and to identify the most common reported characteristics of child
abuse perpetrators in the literature globally. A systematic search of articles published between 2013 and
2018 was conducted in several databases (Scopus, Ovid Medline, EBSCOhost and Google Scholar). Fourteen
studies met the inclusion criteria and were included in the review. The risk factors and characteristics of
child abuse perpetrators are classified into three different levels; individual, relationship and community.
The most common reported characteristics are at the individual level. Family background plays an important
role in determining the risk of being a child abuse perpetrator. Low socioeconomic status of the family is the
prominent contributing risk factor for abusing own children.

MeSH terms: Child; Child Abuse; Humans; Risk Factors; Social Class; Violence; MEDLINE
Fulltext Sociodemographic, lifestyle and health factors associated with depression among adults in Malaysia: an ethnic comparison

Cheah, Y.K., Azahadi, M., Phang, S.N., Abd Manaf, N.H.

JUMMEC, 2019;22(1):33-40.
MyJurnal

Background: Depression is a serious mental health illness worldwide. The purpose of the study was to
investigate the relationships between depression and its risk factors of sociodemography, lifestyle, and health
among the adults of the different ethnic groups in Malaysia.

Method: A nationwide database with 10141 observations was used. Multivariable logistic regression analyses
stratified by ethnicity were estimated.

Results: Ethnicity and gender, age, education, marital status and self-rated health were correlated to the
likelihood of having depression. Malay females and smokers (AOR: 2.083) were more likely to suffer from
depression than Malay males (AOR: 0.305) and non-smokers. Higher-income Chinese displayed higher odds of
having depression than lower-income Chinese (AOR: 1.009). Indians and others with secondary-level education
displayed a lower likelihood of developing depression compared to those with primary-level education (AOR:
0.587).

Conclusion: This study could contribute significantly to the formulation and development of an effective
policy directed towards reducing the prevalence of depression in the vulnerable. These were the adults, in
the younger age group, with lower education, with self-rated poor health, being female, unmarried, Malay
and Chinese, and Indians and others. A nationwide policy targeted towards the Malay females to reduce
their depression, with attention to the Chinese with a high income, and to the Indians and others with poor
educational background to improve their knowledge of mental health, would be worthy of consideration.

MeSH terms: Adult; Attention; Depression; Depressive Disorder; Ethnic Groups; Female; Humans; Income; Life Style; Malaysia; Male; Mental Health; Risk Factors; Single Person; Prevalence; Logistic Models; Marital Status

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